EP4233953A3 - Transvascular diaphragm pacing systems - Google Patents

Transvascular diaphragm pacing systems Download PDF

Info

Publication number
EP4233953A3
EP4233953A3 EP23180190.3A EP23180190A EP4233953A3 EP 4233953 A3 EP4233953 A3 EP 4233953A3 EP 23180190 A EP23180190 A EP 23180190A EP 4233953 A3 EP4233953 A3 EP 4233953A3
Authority
EP
European Patent Office
Prior art keywords
tdps
patient
systems
muscle
endovascular
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
EP23180190.3A
Other languages
German (de)
French (fr)
Other versions
EP4233953A2 (en
Inventor
Ramasamy MEYYAPPAN
Joaquin Andres Hoffer
Marcelo Baru
Bernard COQUINCO
Rodrigo Andres SANDOVAL
Jessica Kit-Sum TANG
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Lungpacer Medical Inc
Original Assignee
Lungpacer Medical Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Lungpacer Medical Inc filed Critical Lungpacer Medical Inc
Publication of EP4233953A2 publication Critical patent/EP4233953A2/en
Publication of EP4233953A3 publication Critical patent/EP4233953A3/en
Pending legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
    • A61N1/3611—Respiration control
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0057—Pumps therefor
    • A61M16/0066—Blowers or centrifugal pumps
    • A61M16/0069—Blowers or centrifugal pumps the speed thereof being controlled by respiratory parameters, e.g. by inhalation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
    • A61M16/022—Control means therefor
    • A61M16/024—Control means therefor including calculation means, e.g. using a processor
    • A61M16/026—Control means therefor including calculation means, e.g. using a processor specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0551—Spinal or peripheral nerve electrodes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3601—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of respiratory organs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/36128—Control systems
    • A61N1/36135—Control systems using physiological parameters
    • A61N1/36139—Control systems using physiological parameters with automatic adjustment
    • H—ELECTRICITY
    • H03—ELECTRONIC CIRCUITRY
    • H03M—CODING; DECODING; CODE CONVERSION IN GENERAL
    • H03M9/00—Parallel/series conversion or vice versa
    • H—ELECTRICITY
    • H04—ELECTRIC COMMUNICATION TECHNIQUE
    • H04J—MULTIPLEX COMMUNICATION
    • H04J3/00—Time-division multiplex systems
    • H04J3/02—Details
    • H04J3/06—Synchronising arrangements
    • H04J3/0635—Clock or time synchronisation in a network
    • H04J3/0638—Clock or time synchronisation among nodes; Internode synchronisation
    • H04J3/0658—Clock or time synchronisation among packet nodes
    • H04J3/0661—Clock or time synchronisation among packet nodes using timestamps
    • H04J3/0664—Clock or time synchronisation among packet nodes using timestamps unidirectional timestamps
    • H—ELECTRICITY
    • H04—ELECTRIC COMMUNICATION TECHNIQUE
    • H04J—MULTIPLEX COMMUNICATION
    • H04J3/00—Time-division multiplex systems
    • H04J3/02—Details
    • H04J3/06—Synchronising arrangements
    • H04J3/0635—Clock or time synchronisation in a network
    • H04J3/0638—Clock or time synchronisation among nodes; Internode synchronisation
    • H04J3/0658—Clock or time synchronisation among packet nodes
    • H04J3/0661—Clock or time synchronisation among packet nodes using timestamps
    • H04J3/067—Details of the timestamp structure
    • H—ELECTRICITY
    • H04—ELECTRIC COMMUNICATION TECHNIQUE
    • H04J—MULTIPLEX COMMUNICATION
    • H04J3/00—Time-division multiplex systems
    • H04J3/02—Details
    • H04J3/06—Synchronising arrangements
    • H04J3/0635—Clock or time synchronisation in a network
    • H04J3/0685—Clock or time synchronisation in a node; Intranode synchronisation
    • H04J3/0697—Synchronisation in a packet node
    • H—ELECTRICITY
    • H04—ELECTRIC COMMUNICATION TECHNIQUE
    • H04L—TRANSMISSION OF DIGITAL INFORMATION, e.g. TELEGRAPHIC COMMUNICATION
    • H04L5/00—Arrangements affording multiple use of the transmission path
    • H04L5/22—Arrangements affording multiple use of the transmission path using time-division multiplexing
    • H04L5/24—Arrangements affording multiple use of the transmission path using time-division multiplexing with start-stop synchronous converters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0015—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors
    • A61M2016/0018—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical
    • A61M2016/0024—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical with an on-off output signal, e.g. from a switch
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/05—General characteristics of the apparatus combined with other kinds of therapy
    • A61M2205/054—General characteristics of the apparatus combined with other kinds of therapy with electrotherapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2230/00—Measuring parameters of the user
    • A61M2230/60—Muscle strain, i.e. measured on the user

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Pulmonology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Neurosurgery (AREA)
  • Neurology (AREA)
  • Physiology (AREA)
  • Signal Processing (AREA)
  • Hematology (AREA)
  • Anesthesiology (AREA)
  • Emergency Medicine (AREA)
  • Biophysics (AREA)
  • Cardiology (AREA)
  • Computer Networks & Wireless Communication (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Vascular Medicine (AREA)
  • Physics & Mathematics (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Pathology (AREA)
  • Theoretical Computer Science (AREA)
  • Electrotherapy Devices (AREA)
  • Synchronisation In Digital Transmission Systems (AREA)

Abstract

Transvascular diaphragm pacing systems (TDPS) and methods are disclosed for providing respiratory therapy to a patient. The TDPS can provide rapid insertion and deployment of endovascular pacing electrodes in critically ill patients who require intubation and invasive PPMV in order to support the physiological requirements of the human ventilatory system. The systems and methods make best use of the contractile properties of the diaphragm muscle and prevent muscle disuse and muscle atrophy. This can be carried out by engaging the phrenic nerves using patterned functional electrical stimulation applied to endovascular electrodes that are temporarily and reversibly inserted in central veins of the patient, such as the left subclavian vein and the superior vena cava. The TDPS can be designed to seamlessly interface with any commercially available positive-pressure ventilatory assistance/support equipment such as is commonly in use in hospital intensive care units (ICU) for treating critically ill patients with breathing insufficiencies, pain, trauma, sepsis or neurological diseases or deficits.
EP23180190.3A 2013-06-21 2013-06-21 Transvascular diaphragm pacing systems Pending EP4233953A3 (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
PCT/CA2013/000594 WO2013188965A1 (en) 2012-06-21 2013-06-21 Transvascular diaphragm pacing systems and methods of use
EP13807238.4A EP2863987B1 (en) 2013-06-21 2013-06-21 Transvascular diaphragm pacing systems
US201261662579P 2021-07-27 2021-07-27

Related Parent Applications (2)

Application Number Title Priority Date Filing Date
EP13807238.4A Division EP2863987B1 (en) 2013-06-21 2013-06-21 Transvascular diaphragm pacing systems
EP13807238.4A Division-Into EP2863987B1 (en) 2013-06-21 2013-06-21 Transvascular diaphragm pacing systems

Publications (2)

Publication Number Publication Date
EP4233953A2 EP4233953A2 (en) 2023-08-30
EP4233953A3 true EP4233953A3 (en) 2023-11-01

Family

ID=49767975

Family Applications (2)

Application Number Title Priority Date Filing Date
EP23180190.3A Pending EP4233953A3 (en) 2013-06-21 2013-06-21 Transvascular diaphragm pacing systems
EP13807238.4A Active EP2863987B1 (en) 2013-06-21 2013-06-21 Transvascular diaphragm pacing systems

Family Applications After (1)

Application Number Title Priority Date Filing Date
EP13807238.4A Active EP2863987B1 (en) 2013-06-21 2013-06-21 Transvascular diaphragm pacing systems

Country Status (8)

Country Link
US (7) US20150265833A1 (en)
EP (2) EP4233953A3 (en)
JP (5) JP6359528B2 (en)
CN (1) CN104684614B (en)
AU (1) AU2013280184B2 (en)
BR (1) BR112014032002A2 (en)
CA (2) CA2877049C (en)
WO (1) WO2013188965A1 (en)

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